Capacity-Building healthcare professionals to enhance the management radical cure for uncomplicated Plasmodium vivax Malaria

Abstract

This study aims to 1) develop and evaluate an improvement of knowledge and understanding of healthcare personnel regarding Plasmodium vivax malaria radical cure treatment in uncomplicated malaria patients 2) develop and evaluate the monitoring of adverse events in patients receiving radical cure treatment according to treatment guideline for radical cure of uncomplicated Plasmodium vivax Malaria and 3) develop and evaluate the improvement knowledge in quantitative G6PD testing to support treatment guideline for radical cure of uncomplicated Plasmodium vivax Malaria .The sample size includes physicians, pharmacists, medical technologists, nurses, laboratory staffs, public health officers, and malaria-related personnel, with the study conducted across six high-risk provinces (Tak, Mae Hong Son, Kanchanaburi, Phetchaburi, Ratchaburi, and Prachuap Khiri Khan) and 29 hospitals, involving 111 participants. Data was collected from October 2023 to May 2024 through workshop-based training. Study tools included 1) A 20-questions knowledge test administered before and after training 2) Manual for facilitators to conduct training for health personnel 3) G6PD Biosensor device. Data analysis included frequency, percentage, mean, standard deviation, and paired t-tests to assess differences in pre- and post-training scores.
The results of the situation analysis showed the need to implement measures to reduce malaria transmission by using radical cure treatment for Plasmodium vivax. This requires improving the capacity of health personnel through knowledge enhancement, adverse event monitoring, and quantitative G6PD testing. The researchers developed and evaluated an intervention focused on capacity building in knowledge, G6PD testing, and adverse event monitoring among the sample population. Evaluation for increase knowledge and understanding of Plasmodium vivax malaria, pre-training knowledge scores averaged 10.26 (SD±3.62), rising to 16.18 (SD±2.67) post-training, with a statistically significant improvement (P-value < 0.01). Evaluation for development on adverse event monitoring based on data from Thai Vigibase database, showed no adverse events were reported for both the 7-day regimens of tafenoquine and primaquine from January to September 2024. The evaluation of enhancing knowledge in quantitative G6PD testing, post-training participants achieved an average score of 8.87 out of 10 (SD±0.8) in quantitative G6PD testing and result interpretation. Among 1,610 tests conducted, 69.07% of patients showed normal enzyme levels, 20.50% had partial enzyme deficiency, and 10.43% had full enzyme deficiency.
This study demonstrates that training can significantly improve the competency of hospital healthcare personnel, enhancing their knowledge for the appropriate treatment of Plasmodium vivax malaria following treatment guidelines. This contributes to improved treatment quality and a reduction in mortality from malaria-related adverse drug reactions. In 2024, malaria-related deaths decreased to two cases (as of October 26, 2024), down from four in 2023. This progress supports the development of an effective radical cure system for Plasmodium vivax malaria, aligning with the Ministry of Public Health's goal to eliminate malaria by 2026, with ongoing capacity-building monitoring.